The overarching goal of this Mentored Career Development Award (K01) is to provide the applicant with skills to establish an independent program of research focused on improving family-focused community services for children, by greater attention to and understanding of the parent and family contextual variables (P/FCVs) that impact services. The proposed K01 study seeks to examine clinician's abilities to systematically assess for P/FCVs and understand clinical decision-making practices in usual care related to P/FCVs. The outcomes will provide information relevant to tailoring empirically supported interventions to the needs of diverse, complex families. The award will build upon the applicant's strong existing training in tailoring treatments, clinical decision-making models, empirically supported treatments, parent-training interventions, and delivering care in community mental health clinics. The proposed training goals provide instruction and mentoring in (1) identification and assessment of P/FCVs (2) methods for studying decision-making in the context of usual practice (3) utilizing qualitative methods, (4) advanced statistical topics focusing on modeling techniques and longitudinal data analysis and (5) ethical conduct of research. The research plan is divided into three phases; each studying community outpatient services for children with disruptive behavior disorders. Phase 1 research will 1) identify P/FCVs that impact treatments according to parent, youth & clinician perspectives and the empirical literature and 2) examine assessment of P/FCVs in usual care and compare to standardized assessment and 3) examine clinical decision-making practices. Phase II will examine the impact of contextual factors on the delivery and receipt of services and test the linkage between P/FCVs and treatment process variables (i.e. attrition, dosage, intensity, alliance, compliance with therapeutic strategies). Phase III will develop and test for feasibility simplified decision-making tree/s to be used in usual care to tailor treatments to P/FCVs. The training activities and study results will form the basis for examining clinical decision-making guidelines (R01) based on simple heuristic models to tailor treatments to the complexities of "real world" families. [unreadable] [unreadable]